We are not able to meet our obligations for the future. See The Actual Total US Debt ($120 trillion). Currently, most politicians are not making a choice, except for the brave few. And most do not understand the problem.
Take this funding example that is true of what we are putting in over the years, per person, plus the earnings on the money versus what we are taking out in terms of Medicare payments. If we don't put in enough to cover our future benefits, then future taxpayers are stuck for the difference. Do you choose that or some more balanced approach.
Choose which strategy you would stand by:
MONEY IN MONEY OUT NET DEFICIT
WE PAY IN EARNINGS (SPENT) (Paid by future taxpayers)
Situation: Now 114K 15K 335K 206K
___ A. Do nothing Future tax payers pay all
___ B. Pay more in 300K 35K 335K 0 !
(2.6 times as much) We pay for ourselves!
___ C. Take out less in benefit, no change in pay in 114K 15K 129K 206K
(alot less received)
___ D. Pay some more in, reduce benefitssome 200K 20K 220K 0 !
___ E. Combination
Pay no more in 114K 15K
Pay out at later age
(= pay out less over the years) Less $ out
Higher income people get less Less $ out
Lower income people get more, so covered More
Total 129K 0!
The money out numbers are slightly out of proportion but the idea is clear about the choices we have. The last combination plan is basically Ryan's plan, which does not in fact eliminate Medicare, but it does alter things so that those who are better off give up their benefits for the benefit of those who need them and it doesn't lead to bankruptcy (which means the government reneges on its promise).
Social security is a ponzi scheme, in a nonillegal sense, in that people who come in later are often left footing the bill (paying the penalty for others not paying in enough). Underfunding of all these programs has the same effect and the same choices as a ponzi scheme. People who find the term "ponzi scheme" to be offensive might better focus on how offensive it is to dump our shortfall onto others to pay for us. See the Medicare section for another treatment of the options.
DISCUSSION, AFTER YOU'VE MADE YOUR CHOICE
I hope these choices have you understanding more of what the practical considerations and tradeoffs are, without getting emotional about someone "taking away my benefits and being cruel to old people!" The government running out of money to cover this is the key cruelty - and those believing that we will have enough money to pay all of this without great financial sacrifice are the ones being inadvertently cruel to someone (the taxpayer at some point). The money needed must come from somewhere, not the magic fairy, and that somewhere is the taxpayer. Yes, the taxpayer would have to cover it, so you might say "no sweat, man, I got this covered" - but it is "big sweat, man", as taxpayer would have to pay in enormously greater percentages, which would then squeeze their personal budgets and lower their standard of living. On top of that the economy would be hurt, which causes another harmful effect.
The net effect on the taxpayers, in summary, could be this double whammy:
1. Pay double the taxes (imagine what that would do to individual budgets and the standard of living).
2. With a large downward effect on the economy (reducing incomes from which to pay taxes and living expenses.
Responsibility says this is mandatory to deal with
There is no other option, we've got to deal with this or suffer the consequences, which would definitely be unacceptable.
And we've got to make the choice responsibly, which means "soon", not kicking the can down the road.
When do we need to face up to it? Some people would wait until we're forced to do so, when it'll be too late and the huge consequences are unavoidable. I think a responsible person would deal with it now, not later.
I would also not support a President who doesn't deal with this, regardless of ideology or who I like, as this is our most significant issue.
The alternative to pick
It is, of course, obvious that the rational choice is E, as it doesn't cost us more now (though we may have to up it a bit).
The tradeoff of course is that we don't start collecting benefits until a later age - and if we collect later we are therefore collecting less because there are fewer years of pay out.
The other tradeoff is one which you'll not have to suffer, as it will be a free lunch, unless you are a higher income person who doesn't really need Medicare. Of course, this means that the higher income person is paying a tax into the "fund" from which he/she does not receive a benefit, so it is a tax for the rich for the benefit of the poor. But that is not unreasonable - and I don't think it is damaging to the higher income person.
But the great advantage is that the poor people will be funded from the higher income's portion of what the fund would be for them.
So, everybody is covered and no one is left out in the cold. And no one is harmed by the lack of Medicare.
Yes, it would end "Medicare as we know it", a phrase which the detractors use. However, with no alternative plan, the detractors would, indeed, end Medicare as we know it because Medicare would be screwed, literally, with millions of people harmed by the failure to consider the consequences.